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  • Title: Stage of behavior change for condom use: the influence of partner type, relationship and pregnancy factors.
    Author: Santelli JS, Kouzis AC, Hoover DR, Polacsek M, Burwell LG, Celentano DD.
    Journal: Fam Plann Perspect; 1996; 28(3):101-7. PubMed ID: 8827145.
    Abstract:
    A theoretical model was used to examine the influence of relationship factors, pregnancy intentions, contraceptive behavior and other psychosocial characteristics on stages of behavior change in condom use among heterosexual black women of reproductive age. Data from an inner-city street survey compared women who were not contemplating condom use, women who were attempting to use condoms or had used them consistently for short periods of time, and those who had achieved long-term consistent use. Women's relationship with their main partner appears to be an important factor in understanding their use of condoms both with main partners and with other partners. For condom use with the main partner, factors such as emotional closeness and partner support were significant predictors of the likelihood that women would be attempting to use condoms rather than not contemplating use. Cohabitation and the belief that condom use builds trust were significant predictors of long-term consistent condom use. Having a regular or main partner was strongly associated with intentions to use condoms with other partners. Women who wanted to become pregnant were much less likely to intend to use condoms with their main partner, and women using oral contraceptives were less likely to be long-term consistent condom users. This study examines the influence of five groups of factors on the stages of change in condom use among Black women in Baltimore, Maryland, in 1993. The stages of change included: precontemplation, contemplation, ready for action, action, and maintenance. Interviews were obtained from women aged 17-35 years in designated neighborhoods. The sample included 625 women equally divided among age groups 17-20 years, 20-24 years, and 25-35 years. 63% of the 625 women had a main sexual partner and 42% had other partners, of which 33% had a main partner and other partners. Most women with main partners were in the precontemplation stage (50%) and most women with other partners were in the maintenance stage (41%). Women with main and other partners were primarily in the maintenance stage (37%). Few were classified as being in the contemplation or action stages. Changes between the precontemplation stage and the middle stage are viewed as "developing intentions." Changes between the middle stage and maintenance stage are viewed as "using consistently." Condom use with a main partner was associated with all five groups of factors: demographic, social, pregnancy intentions, outcome expectations or HIV risk, and efficacy. Having a regular partner who supported condom use significantly increased the odds of developing intentions to use condoms and of using condoms consistently. Friends support of condom use and condom use among friends raised the odds of becoming a consistent condom user. Having two or more partners and having one or more HIV risk factors was positively associated with the likelihood of consistent condom use. The strongest effects on developing intentions to use condoms with a main partner were emotional closeness, partner support for condom use, and women's potential happiness if pregnancy was an outcome. Consistent condom use with a main partner was predicted best by cohabitation with the main partner, use of the pill at the last intercourse, and the belief in condoms as a means of building trust. Prediction among other partners was more difficult.
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